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This open access book describes and illustrates the surgical techniques, implants, and technologies used for the purpose of personalized implantation of hip and knee components. This new and flourishing treatment philosophy offers important benefits over conventional systematic techniques, including component positioning appropriate to individual anatomy, improved surgical reproducibility and prosthetic performance, and a reduction in complications. The techniques described in the book aim to reproduce patients’ native anatomy and physiological joint laxity, thereby improving the prosthetic hip/knee kinematics and functional outcomes in the quest of the forgotten joint. They include kinematically aligned total knee/total hip arthroplasty, partial knee replacement, and hip resurfacing. The relevance of available and emerging technological tools for these personalized approaches is also explained, with coverage of, for example, robotics, computer-assisted surgery, and augmented reality. Contributions from surgeons who are considered world leaders in diverse fields of this novel surgical philosophy make this open access book will invaluable to a wide readership, from trainees at all levels to consultants practicing lower limb surgery
Pathological conditions affecting the hip and knee joints occupy a particular place amongst the important orthopaedic entities affecting the extremities. On the one hand they are relatively frequent and on the other they mean for the patient limitation of his ability to walk, because of their considerably detrimental effects. A purposeful basic treatment of these joint diseases (and here osteoarthritis takes pride of place) is only possible if it stems from a reliable biomechanical analysis of the normal and patho logical stressing of the joint in question. Whilst the situation in the hip can be considered to be fundamentally clarified, a com prehensive representation of the knee is still lacking particularly when taking into account the latest knowledge of biomechanics. Recently our concepts of the kinematics of the knee have been completely changed, but the clinically important question of articular stressing remains unanswered. Dr. Maquet has carried out pioneer work in this field for some years in adapting, by analogy, to the knee joint, principles already accepted for the hip joint. Since the knee is not a ball and socket joint, a complicated problem arises for which new thoughts are necessary. The results of the numerous operations carried out by Dr. Maquet according to the biomechanical con siderations, demonstrate that his thinking is fundamentally correct. Above all, it is here again proven (as earlier in the case of the hip) that healing of osteoarthritis depends decisively on reducing and evenly distributing joint pressure.
This book presents a fundamental basic overview of orthopedic biomechanics in sports medicine, with a special focus on the current methodologies used in modeling human joints, ligaments, and muscle forces. The first part discusses the principles and materials, including the use of finite element analysis (FEA) to analyze the stress-strain response in the implant-bone interface and design. The second part focuses on joint-specific biomechanics, highlighting the biomechanics of the knee and shoulder joints, their modeling, surgical techniques, and the clinical assessment of joint performance under various kinematic conditions resulting from different repair techniques. Written by international experts working at the cutting edge of their fields, this book is an easy-to-read guide to the fundamentals of biomechanics. It also offers a source of reference for readers wanting to explore new research topics, and is a valuable tool for orthopedic surgeons, residents, and medical students with an interest in orthopedic biomechanics.​
The Multiple Ligament Injured Knee: A Practical Guide to Management includes the most developed knowledge needed to successfully diagnose and treat knee ligament injuries. This thorough work presents anterior and posterior cruciate and collateral ligament anatomy and biomechanics along with non-invasive methods for diagnosing the extent of injury, such as radiographic and arthroscopic evaluation. Various injuries are discussed in addition to useful treatment techniques, including arthroscopic reconstruction, posterolateral and posteromedial corner injury and treatment, assessment and treatment of vascular injuries, assessment and treatment of nerve injuries, rehabilitation, and post-operative results. Each of these clearly written chapters is accompanied by a wealth of line drawings and photographs that demonstrate both the surgical and non-surgical approaches to examination and treatment.
This book provides detailed guidance on knee arthroscopy that reflects the very latest advances in this ever-changing field. Among the techniques covered are reconstruction of the anterior and posterior cruciate ligaments, meniscal repair and transplantation, cartilage repair by means of osteochondral allograft transplantation and autogenous osteochondral transfer, medial patellofemoral ligament reconstruction, and high tibial osteotomy. In each case, clear descriptions of technique are supported by a wealth of high-quality illustrations, with identification of potential pitfalls and how to avoid them. In addition, the latest knowledge is presented on anatomy and biomechanics. The book is written by recognized experts in sports injuries and knee disorders. It will serve as an up-to-date reference for the experienced knee surgeon and an ideal source of information for all who wish to broaden their knowledge of and improve their skills in knee arthroscopy, whether general orthopaedists, orthopaedic trainees, or sports medicine physicians.
This book provides detailed information on functional anatomy, physical examination, and clinical radiology of the shoulder with a view to enabling the clinician to identify the most suitable treatment approach to different shoulder joint pathologies. In addition, it describes the arthroscopic treatment techniques most frequently employed in patients with these conditions and presents numerous arthroscopic images detailing characteristic findings. The shoulder is widely regarded as the most complex joint in the human body, displaying the widest range of motion. Knowledge of normal and pathological anatomy, ability to perform a proper physical examination, and appropriate selection of imaging modalities and interpretation of imaging appearances, often in close collaboration with an imaging expert, are all vital for correct diagnosis and choice of treatment approach. Surgeons and trainees will find this richly illustrated book to be an excellent educational guide and an instructive source of stepwise guidance from clinical presentation to achievement of desired treatment outcomes.
The problems of the patellofemoral joint remain a challenge to the orthopaedic surgeon. In spite of many articles in scientific journals, an outstanding monograph, and several excellent textbook chapters, the patella is still an enigma in many respects. The etiology of patellar pain is controversial, and there is no completely satisfying explanation for its cause or its relationship to chondromalacia. Curiously, neither the widespread use of arthroscopy nor the advent of newer diagnostic tests such as CT scanning and magnetic resonance imaging have cast much light. Without a better understanding of why patellar disorders occur it is not surprising that there is no consensus on how to fix them. Arthros copy has contributed little except to the patient's psyche. The currently most popular surgical treatment for recurrent dislocation of the patella was first described 50 years ago. One concrete advance, albeit a small one, is a better understanding of the role of anatomical abnormalities and patellofemoral dysplasia in patellar instabilities. It gives me great pleasure that many of the contributors are, like Dr.
Worldwide experience with the Lcs• mobile bearing total knee prosthesis has been unpar alleled both in terms of enduring popularity and outstanding long-term clinical results. Buechel and Pappas's design was based on the principles of; restoring anatomical joint function to as near normal as possible, minimising contact stresses to avoid wear and darn age to the bearing surfaces. and finally the idea that constraint should refiect the need for mobility, to avoid shear stresses and loosening of the implant. In 1977, the LCS® knee was implanted by Dr. Frederick Buechel. This was the first mobile bearing, tri-compartmental knee implant. This was also the first to successfully address the key issues ofloosening, wear and patello-femoral problems associated with earlier designs. The unique design solution was the creation of a common articulating geometry for the tibia and patella on the distal femoral surface. This resulted in a tibial and patellar articulation that was mobile in nature, but with an identical radius of curvature and conformity. The mobile bearing concept was considered sufficiently novel and unproven that the US FDA (Food & Drug Administration) required that it be validated in an Investigational Device Evaluation (IDE). An FDA IDE study involving 25 US surgeons was initiated in 1981. Validation of the clinical success of the device in this study resulted in FDA approval of the LCS, Knee (for cemented, tri-compartmental use) in 1985.
This book provides state-of-the-art and up-to-date discussions on the pathology-related considerations and implications in the field of orthopaedic biomechanics. It presents fundamental engineering and mechanical theories concerning the biomechanics of orthopaedic and anatomical structures, and explores the biological and mechanical features that influence or modify the biomechanics of these structures. It also addresses clinically relevant biomechanical issues with a focus on diagnosis, injury, prevention and treatment. The first 12 chapters of the book provide a detailed review of the principles of orthopaedic biomechanics in the musculoskeletal system, including cartilage, bone, muscles and tendon, ligament, and multiple joints. Each chapter also covers important biomechanical concepts relevant to surgical and clinical practice. The remaining chapters examines clinically relevant trauma and injury challenges in the field, including diagnostic techniques such as movement analysis and rehabilitation intervention. Lastly it describes advanced considerations and approaches for fracture fixation, implant design, and biomaterials.